A stent graft for placement in the thoracic arch of a patient has a tubular body defining a main lumen therethrough, a plurality of zig zag stents along the tubular body, each of the stents comprising a plurality of struts and bends, the bends being between adjacent struts. At least a first stent and an adjacent second stent having at least a pair of adjacent bends on the first stent aligned with an adjacent pair of bends on the second stent, whereby a first pair of adjacent struts of the first stent and a second pair of adjacent struts of the second adjacent stent together define a diamond shape region. A recess is within the diamond shaped region with the recess extending into the lumen of the tubular body. A fenestration extending into the tubular body within the recess in the diamond shaped region and a graft tube leading from the fenestration into the main lumen. There can be one, two or three diamond shaped regions, recesses, fenestrations and graft tubes. Proximally of the or each diamond shaped region the tubular body has a first diameter, distally of the diamond shaped region the tubular body has a second diameter and in the region of the tubular body around the diamond shaped region the tubular body has a third diameter, the first diameter being greater than the second diameter and both the first and second diameter being greater than the third diameter whereby a central region is defined which will allow circumferential blood flow during an operation out of the graft tube into the recess and then into the central region.
